Definition: Sexually transmitted diseases (STDs) are infections that you can get from having sex with

someone who has the infection. The causes of STDs are bacteria, parasites and viruses. There are more than 20 types of STDs, including

Chlamydia Gonorrhea Genital herpes HIV/AIDS HPV Syphilis Trichomoniasis

Most STDs affect both men and women, but in many cases the health problems they cause can be more severe for women. If a pregnant woman has an STD, it can cause serious health problems for the baby. Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are generally acquired by sexual contact. The organisms that cause sexually transmitted diseases may pass from person to person in blood, semen, or vaginal and other bodily fluids. Some such infections can also be transmitted nonsexually, such as from mother to infant during pregnancy or childbirth, or through blood transfusions or shared needles. It's possible to contract sexually transmitted diseases from people who seem perfectly healthy people who, in fact, aren't even aware of being infected. Many STDs cause no symptoms in some people, which is one of the reasons experts prefer the term "sexually transmitted infections" to "sexually transmitted diseas SIGNS & SYMPTOMS Sexually transmitted infections (STIs) have a range of signs and symptoms. That's why they may go unnoticed until complications occur or a partner is diagnosed. Signs and symptoms that might indicate an STI include:

Sores or bumps on the genitals or in the oral or rectal area Painful or burning urination Discharge from the penis Vaginal discharge Unusual vaginal bleeding Sore, swollen lymph nodes, particularly in the groin but sometimes more widespread Lower abdominal pain Rash over the trunk, hands or feet

Signs and symptoms may appear a few days to years after exposure, depending on the organism. They may resolve in a few weeks, even without treatment, but progression with later complications or recurrence sometimes occurs.

CAUSES Sexually transmitted infections can be caused by:

Bacteria (gonorrhea, syphilis, chlamydia) Parasites (trichomoniasis) Viruses (human papillomavirus, genital herpes, HIV) Sexual activity plays a role in spreading many other infectious agents, although it's possible to be infected without sexual contact. Examples include the hepatitis A, B and C viruses, shigella, cryptosporidium and Giardia lamblia.

RISK FACTOR Anyone who is sexually active risks exposure to a sexually transmitted infection to some degree. Factors that may increase that risk include:

Having unprotected sex. Vaginal or anal penetration by an infected partner who is not wearing a latex condom transmits some diseases with particular efficiency. Without a condom, a man who has gonorrhea has a 70 to 80 percent chance of infecting his female partner in a single act of vaginal intercourse. Improper or inconsistent use of condoms can also increase your risk. Oral sex is less risky but may still transmit infection without a latex condom or dental dam. Dental dams thin, square pieces of rubber made with latex or silicone prevent skin-to-skin contact. Having sexual contact with multiple partners. The more people you have sexual contact with, the greater your overall exposure risks. This is true for concurrent partners as well as monogamous consecutive relationships. Having a history of STIs. Being infected with one STI makes it much easier for another STI to take hold. If you're infected with herpes, syphilis, gonorrhea or chlamydia and you have unprotected sex with an HIV-positive partner, you're more likely to contract HIV. Also, it's possible to be reinfected by the same infected partner if he or she isn't also treated. Abusing alcohol or using recreational drugs. Substance abuse can inhibit your judgment, making you more willing to participate in risky behaviors. Injecting drugs. Needle sharing spreads many serious infections, including HIV, hepatitis B and hepatitis C. If you acquire HIV by injecting drugs, you can transmit it sexually. Being an adolescent female. In adolescent girls, the immature cervix is made up of constantly changing cells. These unstable cells make the adolescent female cervix more vulnerable to certain sexually transmitted organisms.

DIAGNOSIS

Blood tests. Blood tests can confirm the diagnosis of HIV or later stages of syphilis. Urine samples. Some STIs can be confirmed with a urine sample. Fluid samples. If you have active genital sores, testing fluid and samples from the sores may be done to diagnose the type of infection. Laboratory tests of material from a genital sore or discharge are used to diagnose the most common bacterial and some viral STIs at an early stage. COMPLICATION Possible complications include:

Sores or bumps anywhere on the body Recurrent genital sores Generalized skin rash Pain during intercourse Scrotal pain, redness and swelling Pelvic pain Groin abscess Eye inflammation Arthritis Pelvic inflammatory disease Infertility Cervical cancer Other cancers, including HIV-associated lymphoma and HPV-associated rectal and anal cancers Opportunistic infections occurring in advanced HIV Maternal-fetal transmission, which causes severe birth defects

TREATMENT AND DRUGS

Antibiotics. Antibiotics, often in a single dose, can cure many sexually transmitted bacterial and parasitic infections, including gonorrhea, syphilis, chlamydia and trichomoniasis. Typically, you'll be treated for gonorrhea and chlamydia at the same time because the two infections often appear together. Once you start antibiotic treatment, it's crucial to follow through. If you don't think you'll be able to take medication as prescribed, tell your doctor. A shorter, simpler treatment regimen may be

available. In addition, it's important to abstain from sex until you've completed treatment and any sores have healed. Examples of antimicrobial (drug) resistance:

Methicillin-Resistant Staphylococcus aureus (MRSA) Vancomycin-Resistant Enterococci(VRE)

Antiviral drugs. You'll have fewer herpes recurrences if you take daily suppressive therapy with a prescription antiviral drug, but you can still give your partner herpes at any time. Antiviral drugs can keep HIV infection in check for many years, although the virus persists and can still be transmitted. The sooner you start treatment, the more effective it is. Once you start treatment if you take your medications exactly as directed it's possible to lower your virus count to nearly undetectable levels. EXAMPLE OF ANTI-VIRAL DRUGS: Acyclovir, famciclovir, valacyclovir PREVENTIVE There are several ways to avoid or reduce your risk of sexually transmitted infections.

Abstain. The most effective way to avoid STIs is to abstain from sex. Stay with 1 uninfected partner. Another reliable way of avoiding STIs is to stay in a long-term mutually monogamous relationship with a partner who isn't infected. Get vaccinated. Getting vaccinated early, before sexual exposure, is also effective in preventing certain types of STIs. Vaccines are available to prevent two viral STIs that can cause cancer human papillomavirus (HPV), hepatitis A and hepatitis B. The Centers for Disease Control and Prevention (CDC) recommends the HPV vaccine for girls and boys ages 11 and 12. If not fully vaccinated at ages 11 and 12, the CDC recommends that girls and women through age 26 and boys and men through age 26 receive the vaccine. The hepatitis B vaccine is usually given to newborns. Wait and verify. Avoid vaginal and anal intercourse with new partners until you have both been tested for STIs. Oral sex is less risky, but use a latex condom or dental dam a thin, square piece of rubber made with latex or silicone to prevent direct contact between the oral and genital mucous membranes. Keep in mind that human papillomavirus (HPV) screening isn't available for men, and no good screening test exists for genital herpes, so you may not be aware you're infected until you have symptoms. It's also possible to be infected with an STI yet still test negative. Use condoms and dental dams consistently and correctly. Use a new latex condom or dental dam for each sex act, whether oral, vaginal or anal. Never use an oil-based lubricant, such as petroleum jelly, with a latex condom or dental dam. Keep in mind that while condoms reduce your risk of exposure to most STIs, they provide a lesser degree of protection for STIs involving exposed genital sores, such as human papillomavirus (HPV) or herpes. Also, nonbarrier forms of contraception, such as oral contraceptives or intrauterine devices, don't protect against STIs.

Don't drink alcohol excessively or use drugs. If you're under the influence, you're more likely to take sexual risks. Avoid anonymous, casual sex. Don't look for sex partners online or in bars or other pickup places. Not knowing your sex partner well increases your risk of possible exposure to an STI. Communicate. Before any serious sexual contact, communicate with your partner about practicing safer sex. Reach an explicit agreement about what activities will and won't be OK. Teach your child. Becoming sexually active at a young age tends to increase a person's number of overall partners and, as a result, his or her risk of STIs. Biologically, young girls are more susceptible to infection. While you can't control your teen or preteen's actions, you can help your child understand the risks of sexual activity and that it's OK to wait to have sex. Consider male circumcision. There's evidence that male circumcision can help reduce a man's risk of acquiring HIV from an infected woman (heterosexual transmission) by 50 to 60 percent. Male circumcision may also help prevent transmission of genital HPV and genital herpes. Consider the drug Truvada. In July 2012, the Food and Drug Administration (FDA) approved the use of the drug Truvada (a fixed dose combination of emtricitabine/tenofovir disoproxil fumarate) to reduce the risk of sexually transmitted HIV infection in those who are at high risk. Truvada is also used as an HIV treatment along with other medications. When used to help prevent HIV infection, Truvada is only appropriate if your doctor is certain you don't already have an HIV or hepatitis B infection. The drug must also be taken daily, exactly as prescribed. And it should only be used along with other prevention strategies such as condom use every time you have sex.

COPING AND SUPPORT Here's how you can cope:

Put blame on hold. Don't jump to the conclusion that your partner has been unfaithful to you. One (or both) of you may have been infected by a past partner. Be candid with health care workers. Their job is not to judge you, but to stop STIs from spreading. Anything you tell them remains confidential. Contact your health department. Although they may not have the staff and funds to offer comprehensive services, local health departments maintain STI programs that provide confidential testing, treatment and partner services.